Clinical Assessment

Written by Chris Heywood

The clinical assessment of a patient is the most important part of the recovery process. Although specific diagnoses can sometimes be hard, identifying the most likely pain generating structures is crucial in directing your future care effectively.

We normally split the assessment into two main categories:

  • Subjective
  • Objective

Subjective

This is the interview if you like. You will be asked about the history of your present complaint, how it happened, when it occurred, what does it feel like, what makes it worse or better, what treatment have you already had, what medications are you taking etc. In some scenarios the cause of the problem is obvious and so this part of the examination can be quite fast. In more complex cases experienced physiotherapists will often spend a lot of time exploring this area because we can often gain vital information, some which you will never have linked otherwise, that only this type of questioning will gather.

The subjective examination provides the therapist with the information needed to make a hypothetical diagnosis in their mind so that when they progress to the objective phase, this can be targeted very specifically to confirm or refute this diagnosis.

Objective

This is the ‘hands on’ part of the examination. The physiotherapist will undertake a plethora of special tests and look at you postures, movements, strengths, weaknesses and any other components they feel appropriate. They will need to thoroughly examine the point of injury and any other related structures so please remember this when choosing your attire!! Physiotherapists are generally very used to the human body but you must feel comfortable as the patient so please bare this in mind. For those of you with running or impact related injuries, especially in the lower limbs, it can be advisable to bring your trainers along so that we can see you in your real time postures.

We may also take you down to our gym where we can use a variety of equipment such as weights, resistance structures, steps, running machines, or even our ‘catwalk’ to further our understanding of your presentation.

This part of the examination may also be used to look at any imagery such as X-Rays or scans that are relevant to your complaint.

A summary of the therapist’s findings will then be fully explained to you in easy to understand language, often accompanied with demonstrations or visual aids such as posters or our various model body parts! A treatment plan will be formulated with your input thus empowering you as the patient to become the most important part of the recovery process. What we can do in 40 minutes is perhaps less important that what you can do in the other 6 days, 23 hours and 20 minutes of the week!

From here you treatment will proceed, either by active intervention by the therapist, your own self care or possibly a referral to a specialist if necessary.